Biomedical subjects

Kazimierz Rembiasz

Publications and source records attributed to Kazimierz Rembiasz.

13 recordsLinked to original sources

PubMed2006

Effects of cyclooxygenase-2 inhibition on serum and tumor gastrins and expression of apoptosis-related proteins in colorectal cancer.

The objective of the present study was to determine the influence of cyclooxygenase-2 (COX-2) inhibition by Celecoxib (CLX) in humans with distal colorectal adenocarcinoma (CRC) on serum and tumor levels of progastrin and gastrin and serum levels of proinflammatory cytokines (IL-8, TNF-alpha). In addition, the effects of this CLX treatment on tumor and adjacent mucosa expression of gastrin, its receptors (CCK2), and COX-1 and COX-2, as well as protein expression of the active form of nuclear factor kappa B (NFkappa B) and the apoptotic-related proteins Bcl-2 and survivin, have been examined. Ten distal CRC patients were examined twice, once before and then after 14-day treatment with CLX (200 mg bid). Large biopsy samples were taken from the tumor and intact mucosa 10 cm above the tumor. For comparison, 20 age- and sex-matched healthy controls were enrolled and treated with CLX as CRC patients. Serum levels of IL-8 and TNF-alpha were measured by enzyme-linked immunosorbent assay, and serum levels of amidated gastrins and progastrin, by specific radioimmunoassay. The gene or protein expressions of progastrin, gastrin, CCK2, COX-1, COX-2, Bcl-2, and survivin as well as NFkappa B were determined by RT-PCR or Western blot in biopsy samples of tumor and intact mucosa of CRC patients. Serum IL-8 and TNF-alpha values were severalfold higher in CRC patients than in controls. The increase in serum proinflammatory cytokines was accompanied by increased expression of the active form of NFkappa B. Serum progastrin levels were also found to be significantly higher in CRC than in controls. Treatment of CRC with CLX resulted in a significant decrease in serum levels of progastrin and this was accompanied by an increment in tumor expression of COX-2 with a concomitant reduction in gastrin, Bcl-2, survivin, and NFkappa B expression. We conclude that (1) distal CRC patients show significantly higher serum progastrin levels than matched healthy controls, confirming that this hormone may be implicated in rectal carcinogenesis; (2) CRC patients exhibit significantly higher serum levels of IL-8 and TNF-alpha than healthy controls, probably reflecting more widespread inflammatory reaction in the colonic mucosa in CRC; (3) gastrin, COX-2, Bcl-2, survivin, and NFkappa B were overexpressed in CRC tumor compared to intact mucosa, but treatment with CLX significantly reduced serum levels of progastrin and IL-8 and TNF-alpha, which could mediate the up-regulation of COX-2 in CRC; and (4) CLX also enhanced expression of COX-2, while inhibiting the expression of gastrin, Bcl-2, survivin, and NFkappa B, suggesting that COX-2 inhibition might be useful in chemoprevention against CRC, possibly due to suppression of the antiapoptotic proteins and reduction in progastrin-induced and NFkappa B-promoted tumor growth.

Adenocarcinoma↗

PubMed2005

Biomarkers in various types of atrophic gastritis and their diagnostic usefulness.

Atrophic gastritis has been shown to involve either the oxyntic gland area, resulting in hypergastrinemia and hypopepsinogenemia I, the antral gland area, causing hypogastrinemia without change in serum pepsinogen I (diffuse antral gastritis; DAG), or the entire gastric mucosa (multifocal atrophic gastritis; MAG), resulting in both hypogastrinemia and hypopepsinogenemia I; and rare atrophic gastritis limited to the oxyntic gland area, with antibodies against oxyntic cells and/or intrinsic factor (autoimmune metaplastic atrophic gastritis; AMAG). This study was performed on 126 patients with various forms of gastritis and on 126 age- and gender-matched controls, who were subjected to endoscopy with biopsy, H. pylori testing (13C-UBT, serology), assays for serum gastrin and pepsinogen I, and testing for basal and pentagastrin-induced gastric acid secretion. The following groups of patients were examined: group I (N = 22), with AMAG; group II (N = 53), with DAG; group III (N = 51), with MAG; and group IV (N = 126), age- and gender-matched controls without gastritis. The following changes were found. In group I very high serum gastrin and very low pepsinogen I were observed, and all patients were achlorhydric and H. pylori negative. In group II, with low serum gastrin and normal pepsinogenemia and gastric chlorhydria, all patients were H. pylori positive. In group III, with lower serum gastrin and lower pepsinogen I levels and reduced chlorhydria, all patients were also H. pylori positive. And all group IV controls, with normal serum gastrin and pepsinogen I and normal gastric acid secretion without antral or fundic gastritis, were H. pylori negative. We conclude that measurements of serum gastrin and pepsinogen I and gastric acid secretion as well as testing for H. pylori infection may be useful in noninvasive diagnosis of various types of atrophic gastritis and in identification of patients with premalignant gastritis and a high risk of gastric cancerogenesis.

Adult↗

PubMed2005

Multifocal atrophic gastritis: pathogenesis and therapeutic implications.

OBJECTIVE: This study, carried out on 51 patients with multifocal atrophic gastritis (MAG) and 92 age and sex-matched dyspeptic controls, was designed to examine both exocrine (gastric acid) and endocrine (gastrin) gastric secretion before and after therapeutic intervention including Helicobacter pylori eradication and vitamin C treatment. METHODS: Fasting and gastrin-releasing peptide-induced gastric acid secretion, serum levels of gastrin and proinflammatory (IL-1beta, IL-8, TNF-alpha) as well as gastric mucosal gene expression of ornithine decarboxylase (ODC), cyclooxygenase 2 (COX-2) and growth factors (epidermal growth factor and transforming growth factor alpha) were determined before and after the eradication of Helicobacter pylori and therapy with large doses (1 g/d) of vitamin C for 3 months. RESULTS: The H. pylori eradication, assessed by C-urea breath test, and vitamin C therapy failed to reverse the histological atrophy of the gastric mucosa but improved significantly the functional status of the atrophied mucosa, especially its exocrine and endocrine secretory activities, attenuated the expression of premalignant markers such as ODC and COX-2, raised the production of growth factors and diminished the release of proinflammatory cytokines. CONCLUSIONS: These results indicate that MAG may be considered as an environmental disease of the gastric mucosa, whose functional status can be improved by the eradication of H. pylori combined with antioxidant therapy with large doses of vitamin C.

Adult↗

PubMed2005

[Preoperative diagnostics in patients with adrenal tumors].

The aim of the study was analysis of preoperative diagnostics of patients who underwent laparoscopic adrenalectomy. In the preoperative diagnostics in 10 patients (22.2%) pheochromocytoma was found, in 8 (17.8%) Conn's syndrome, in 4 (8.9%) Cushing's syndrome and in 1 (2.2%) adrenal virilization. Full accordance between histopathological findings and preoperative diagnosis was achieved in 91% of cases. Four cases of discrepancy were: 1 false positive preoperative diagnosis of aldosteronoma, 1 false positive and 2 false negative diagnosis of pheochromocytoma.

Adosterol↗

PubMed2004

Implication of peroxisome proliferator-activated receptor gamma and proinflammatory cytokines in gastric carcinogenesis: link to Helicobacter pylori-infection.

Peroxisome proliferator-activated receptor gamma (PPARgamma) is a ligand-dependent transcription factor involved in various processes including the inflammation and carcinogenesis. The aim of the present study was 1) to examine the mRNA and protein expression of PPARgamma in gastric cancer (GC); 2) to evaluate the effect of PPARgamma ligand (ciglitazone) on the proliferation and apoptosis of GC cell line; and 3) to assess the levels of gastric tissue proinflammatory cytokines, IL-1beta and IL-8, and plasma gastrin in GC patients before and after Helicobacter pylori (H. pylori) eradication. The trial material included 30 H. pylori-negative controls and 30 sex- and age-matched GC patients without or with H. pylori before and after its eradication. Expression of tissue PPARgamma, tissue levels of IL-1beta and IL-8, and plasma concentration of gastrin were significantly higher in H. pylori-positive GC compared to controls, but H. pylori eradication significantly reduced these parameters. Kato III cells incubated with alive H. pylori upregulated PPARgamma expression and ciglitazone inhibited cell proliferation and induced apoptosis. PPARgamma, proinflammatory cytokines and plasma gastrin appear to be implicated in H. pylori-related gastric carcinogenesis and PPARgamma agonists may have potential in cancer therapy.

Adult↗

PubMed2003

Gene expression of ornithine decarboxylase, cyclooxygenase-2, and gastrin in atrophic gastric mucosa infected with Helicobacter pylori before and after eradication therapy.

H. pylori (Hp) -induced atrophic gastritis is a well-known risk factor for the development of gastric cancer. Whether Hp eradication can prevent or retard the progress of atrophy and metaplasia has been the topic of numerous studies but the subject remains controversial. Recently, the increased expression of ornithine decarboxylase (ODC), gastrin and cyclooxygenase (COX)-2 has been shown to be increased in premalignant lesions in gastric mucosa and to play an essential role in the malignant transformation. The aim of the study is to assess the effect of eradication therapy on atrophic gastritis and analyze the gene expression for ODC, COX-2 and gastrin in gastric mucosa after succesful eradication in patients with atrophic gastritis. Twenty patients with chronic atrophic gastritis including both corpus and antrum of the stomach were included in this study. Four antral mucosal biopsy specimens were obtained from antrum and four from corpus. The histopathologic evaluation of gastritis was based on Sydney classification of gastritis. All patients were Hp positive based on the [13C] urea breath test (UBT) and the presence of anti-Hp IgG and anti-CagA-antibodies detected by ELISA. The patients were then eradicated with triple therapy consiting of omeprazol (2 x 20 mg), amoxycillin (2 x 1 g) and clarithromycin (2 x 500 mg) for seven days and vitamin C 1 g/day for three months. In gastric mucosal samples obtained from the antrum and corpus before and after eradication, the mRNA expression for ODC, COX-2, and gastrin was assessed by reverse-transcription polymerase chain reaction (RT-PCR). In all patients the gastric secretory analysis was performed by measuring gastric acid output and serum gastrin levels. After triple therapy the successful eradication assessed by UBT was observed in 95% of patients. In 45% of patients the infection with CagA-positive Hp strain was observed. Three months after eradication a significant reduction in the gastric activity (neutrophilic infiltrate) and severity (mononuclear infiltrate) of gastritis was observed. The atrophy score improved in both antrum and corpus after eradication. The expression of COX-2 and ODC was significantly up-regulated in the gastric mucosa of patients with atrophic gastritis and significantly reduced after eradication therapy. In all successfully eradicated patients with atrophic gastritis a significant increase in gastric acid secretion and decrease in serum gastrin were observed. We conclude that: (1) Hp eradication leads to the decrease in ODC and COX-2 gene expression in the gastric mucosa, and this may be relevant for the prevention of the Hp-associated gastric carcinogenesis; and (2) gastric atrophy ameliorates upon successful Hp eradication therapy.

Amoxicillin↗

PubMed2003

[Incidence and risk factors of rebleeding from gastric and duodenal ulcers].

We present the analysis of risk factors of recurrence of bleeding in patients with gastric and duodenal ulcers. The group consisted of 178 patients hospitalized between 1998-2002. Among them there were 76 patients with gastric ulcers and 102 patients with duodenal ulcers. The recurrence of bleeding was observed in 24.3% patients with gastric ulcer and 21.8% of patients with duodenal ulcer. The most important risk factors were: localization of ulcers, intensity of bleeding according to Forrest scale, presence of concomitant diseases, shock on admission and H. pylori infection. 26.3% of patient with gastric ulcer and 36.4% with duodenal ulcer needed emergency operation. The mortality rate among patients with gastric ulcer was 15.6% and with duodenal ulcer 13.6%.

Adult↗

PubMed2003

[Minimally invasive techniques in the treatment of acute biliary pancreatitis].

43 cases of consecutive bilary acute pancreatitis were treated by early endoscopic sphincterotomy and laparoscopic cholecystectomy within first 48 hours after admission. The basic cause of disturbance of bile outflow was microlithiasis. Course of the disease was monitored by level of proinflammatory interleukins in the blood serum of analysed patients. Marked decrease of their level after endoscopic sphincterotomy was observed. This decrease was progressed after laparoscopic cholecystectomy followed by continuos closed lavage of abdominal cavity. Our results indicated that minimally invasive techniques should be done in the early stage of mild and moderate cases of acute biliary pancreatitis.

Acute Disease↗

PubMed2003

[Laparoscopic emergency surgery].

Up-to-dated concepts about the use of laparoscopy in the "acute abdomen" have been discussed. Most frequently performed procedures in abdominal emergency and trauma were presented. Indications, contra-indications, advantages and drawbacks with regard to own 10 years experience and literature were discussed.

Abdomen, Acute↗

PubMed2003

[Acute appendicitis--open or laparoscopic surgery?].

UNLABELLED: Laparoscopy is used more and more frequently in the treatment of abdominal emergencies including acute appendicitis. This technique has a lot of advantages especially in the group of the young female patients, where the differential diagnosis between gynecological diseases and appendicitis is difficult. AIM OF THE STUDY: The study is designed to compare the results of open and laparoscopic exploration in patients with suspected appendicitis. MATERIAL AND METHODS: From 1998-2001 we performed 278 operations for suspicion of appendicitis in the 2nd Dept. of Surgery of the Jagiellonian University. There were 127 laparoscopic procedures performed in 46 men and 81 women (mean age 28.6 years) and 151 classical exploration in 99 men and 52 women (mean age 37.9 years). We reviewed retrospectively the patients' data analysing age, sex, duration of the procedure, length of the hospital stay, intraoperative and postoperative complication rate. RESULTS: The patients operated classically were older than patients operated laparoscopically. The proportion of male and female patients was reversed in both types of exploration. The female patients composed a majority (2/3) in the case of laparoscopic procedures and minority (1/3) in the case of open operations. The average duration of open appendectomy was 43 min. as compared with 49 min. of laparoscopic procedure, which was however getting shorter in the analysed period. The mean length of the hospital stay was twice shorter after laparoscopic appendectomy (4.8 days vs 8.4 days). There were only 4 (3.15%) complications connected with laparoscopic technique and 34 (22.52%) complications after open appendectomy. There were 12 (9.45%) conversions, most of them in patients with the retrocoecal position of the appendix. The diagnosis of acute appendicitis was confirmed in similar percentage in both operation types (laparoscopy--78.74%, open technique--79.47%). There were also similar proportions of the patients with no macroscopical changes in the appendix and with other abdominal diseases. CONCLUSIONS: Laparoscopy allows for the precise diagnosis and final treatment in most patients with the suspected acute appendicitis. Some patients also avoid laparotomy. Hospital stay is significantly shorter and complication rate is markedly lower among patients operated laparoscopically.

Acute Disease↗

PubMed2003

[Well-differentiated papillary mesothelioma--a rare neoplasm of the peritoneum].

Well differentiated papillary mesothelioma (WDPM) is a very uncommon neoplasm of peritoneum. Most frequently it appears like little numerous nodules on peritoneal surface, omentum or mesentery. WDPM is characterized by indolent course and is diagnosed in most cases incidentally during operations for other reasons. Sometimes differentiation between WDPM and other mesothelial lesions may be difficult. In the described case a 22 year old female, cystic peritoneal lesions were first recognized histological as WDPM. In verification after two months, they were proved to be cystic mesotheliosis. WDPM may cause adhesions followed by torsion or strangulation. In the second reported case a 24 year old male, WDPM provokes torsion of the omentum. Twelve months after operation and diagnosis this patient is symptom free.

Adult↗

PubMed2002

mRNA expression of EGF receptor ligands in atrophic gastritis before and after Helicobacter pylori eradication.

BACKGROUND: Epidermal growth factor (EGF) receptor ligands (EGFRL) including transforming growth factor alpha (TGF-alpha), amphiregulin, and heparin binding-EGF (HB-EGF) are involved in gastric mucosal repair in chronic gastritis. Their mRNA expression has been shown to be upregulated after Helicobacter pylori (H.p.)-eradication but little is known about this gene expression in atrophic gastritis. The purpose of our study was to investigate EGFRL mRNA expression in gastric mucosa of patients with atrophic gastritis before and after H.p.-eradication. MATERIAL/METHODS: Antral mucosal biopsies were obtained during endoscopy in 10 H.p. positive patients with atrophic gastritis and in 10 H.p. negative controls with intact mucosa. Total RNA of antral biopsies was extracted and RT-PCR was performed, the PCR-products being measured densitometrically. Values were compared with mRNA expressions in H.p. negative antral mucosa (n=10). RESULTS: Gastric biopsies revealed mRNA expression for TGF-alpha, amphiregulin and HB-EGF, both in H.p. positive atrophic antritis and in H.p. negative healthy mucosa. The mRNA expression of TGF-alpha in atrophic gastritis was significantly upregulated after H.p.-eradication, whereas that of amphiregulin did not change after this eradication. Expression of HB-EGF mRNA was higher in H.p.-infection than after H.p.-eradication or in H.p. negative healthy subjects. CONCLUSIONS: H.p. positive atrophic gastritis is associated with differential mRNA expression of EGF receptor ligands. H.p.-eradication in this entity leads to unequal changes of these growth factor expressions compared to chronic active gastritis without atrophy.

Amphiregulin↗

PubMedDate not supplied

[Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis patients with dysphagia. A preliminary report].

Percutaneous endoscopic gastrostomy (PEG) has been proposed as symptomatic treatment of dysphagia in amyotrophic lateral sclerosis (ALS) patients. The aim of our study was to assess the safety and complications and survival after PEG implantations in 13 ALS patients. We discuss the factors related to survival in two groups: dead (6 out of 13 patients) and alive (7 out of 13) after PEG implantations. We demonstrate that the PEG procedure is quite safe and forced vital capacity (FVC) is a major factor related to survival after PEG implantation in studied patients.

Aged↗